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POSTPARTUM FOLLOW-UP: Can Psychosocial Support Reduce Newborn Readmissions?

Barilla, Dora DrPH, CHES; Marshak, Helen Hopp PhD, CHES; Anderson, S. Eric PhD; Hopp, Joyce W. PhD, RN, CHES

MCN, American Journal of Maternal Child Nursing: January/February 2010 - Volume 35 - Issue 1 - p 33–39
doi: 10.1097/01.NMC.0000366808.75079.cc
Feature Article

Purpose. To determine whether there was a relationship between postpartum psychosocial support from healthcare providers and the rate of normal newborn readmissions (NNRs), and whether there was a cost benefit to justify an intervention.

Study Design and Methods. Data were abstracted for all normal newborn births from 1999 to 2006 (N = 14,786) at a community hospital in southern California at three different time periods: (1) at baseline prior to any intervention (1999–2000), (2) the 4 years during the comprehensive psychosocial support intervention (2001–2004), and (3) the 2 years during a limited psychosocial support intervention (2004–2006). A cost–benefit analysis was performed to analyze whether the financial benefits from the intervention matched or exceeded the costs for NNRs.

Results. There was a significantly lower readmission rate of 1.0% (p = < .001) during the comprehensive intervention time period compared to baseline (2.3%) or to the limited intervention time period (2.3%). Although there was no significant difference in the average cost per newborn readmitted across the three study time periods, during the comprehensive intervention time period the average costs of a NNR were significantly lower ($4,180, p = .041) for the intervention group compared to those who received no intervention ($5,338). There was a cost benefit of $513,540 due to fewer readmissions during the comprehensive time period, but it did not exceed the cost of the intervention.

Clinical Implications. Providing comprehensive follow-up for new mothers in the postpartum period can reduce NNRs, thus lowering the average newborn readmission costs for those who receive psychosocial support. Followup for new mothers should be an accepted norm rather than the exception in postpartum care, but NNRs should not be considered the sole outcome in such programs.

Newborn hospital readmission is a major problem in our healthcare system. Can it be avoided by more careful attention to the new maternal/infant dyad in the home postpartum?

Dora Barilla, DrPH, CHES is an Assistant Professor, Loma Linda University School of Public Health, Loma Linda, CA. She can be reached via dbarilla@llu.edu

Helen Hopp Marshak, PhD, CHES is an Associate Professor, Loma Linda University School of Public Health, Loma Linda, CA.

S. Eric Anderson, PhD is the Chair, Department of Health Policy & Management, Loma Linda University School of Public Health, Loma Linda, CA.

Joyce W. Hopp, PhD, RN, CHES is an Emeritus Distinguished Professor, Loma Linda University School of Public Health, Loma Linda, CA.

The authors have disclosed that there are no financial relationships related to this article.

© 2010 Lippincott Williams & Wilkins, Inc.